| Prime Hospitalist Partners, Llc | |
|
22999 Highway 59 N Kingwood TX 77339-4412 | |
| (281) 348-8001 | |
| Not Available |
| Full Name | Prime Hospitalist Partners, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 22999 Highway 59 N, Kingwood, Texas |
| Authorized Official Name and Position | Pete Beausoleil (CEO) |
| Authorized Official Contact | 8322917532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Hospitalist Partners, Llc 700 Louisiana St Ste 3950 Houston TX 77002-2859 Ph: (832) 390-2646 | Prime Hospitalist Partners, Llc 22999 Highway 59 N Kingwood TX 77339-4412 Ph: (281) 348-8001 |
| NPI Number | 1699342261 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 06/10/2021 |
| Medicare PECOS PAC ID | 2163810342 |
|---|---|
| Medicare Enrollment ID | O20211020000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699342261 | NPI | - | NPPES |
| 188605302 | Medicaid | TX | |
| 8CJ367 | Other | TX | BCBSTX |
| 1994827865 | Other | TX | TRICARE SOUTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly D Petitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194827865 PECOS PAC ID: 3779547120 Enrollment ID: I20070202000215 |
| Provider Name | Lourdes Regina Ticas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184715674 PECOS PAC ID: 7416021290 Enrollment ID: I20080922000058 |
| Provider Name | Bonny Walter Ogar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700171014 PECOS PAC ID: 8527289644 Enrollment ID: I20141014002079 |
| Provider Name | Brenda F Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588040398 PECOS PAC ID: 4284934621 Enrollment ID: I20151208000081 |
| Provider Name | Brenda Vasiljevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417490798 PECOS PAC ID: 0042593907 Enrollment ID: I20170220001696 |
| Provider Name | Nina Fonteneaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407390693 PECOS PAC ID: 6709163470 Enrollment ID: I20170505001022 |
| Provider Name | Anupa Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871017582 PECOS PAC ID: 8022380872 Enrollment ID: I20171114000275 |
| Provider Name | Soumaila Camara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356636476 PECOS PAC ID: 5991188492 Enrollment ID: I20220816002961 |
| Provider Name | Brittany Tralicia Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083306278 PECOS PAC ID: 7416306071 Enrollment ID: I20231208000829 |
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